California's growing nurse practitioner workforce is essential to filling shortages of primary care physicians, but nurse practitioners are not located where they're needed most, according to a study published in Health Affairs.
The lead author, Joanne Spetz, PhD, professor of health economics at University of California San Francisco noted, "California and many other states will need nurse practitioners to meet primary care needs in the future, but need to support strategies to ensure that nurse practitioners work in the places where need is the greatest."
The study examined data from California's 2017 survey of more than 2,000 nurse practitioners and certified nurse midwives. Using the data, researchers looked at employment and practice barriers.
They found "that counties with high density of primary care physicians tended to also have high density of nurse practitioners."
Researchers said nurse practitioners living in counties with low physician and nurse practitioner density were more likely to be nonwhite, educated in California, and to have completed their initial nursing education in an associated degree program.
One challenge the authors point to is that only eight of the state's 23 nurse practitioner education programs are in counties with lower-than-average nurse practitioner and physician density. Dr. Spetz said this may be partially why recent nurse practitioner graduates tend to be located in areas with a high supply of physicians and nurse practitioners.
Researchers also found that recently-graduated nurse practitioners are more likely to have plans to move outside of California in the next five years if they are in counties that have high physician-to-population ratios.
"Expanding education programs in underserved areas, increasing the diversity of the nurse practitioner workforce and ensuring that nurse practitioners feel empowered to fully use their skills are necessary to meet both current and future primary care needs," the study's authors concluded.
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